The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
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J. Matern. Fetal. Neonatal. Med. · Nov 2011
Glucocorticoid receptor expression and cortisol level in cord blood of term infants.
To examine the expression levels of glucocorticoid receptor (GR) isoforms in peripheral blood mononuclear cells (PBMCs) and serum cortisol levels in cord blood from term infants. ⋯ It is considered that glucocorticoid effects could be expected from the fetal period to the neonatal period, because GRalpha expression level was not related to perinatal factors, GRbeta expression level, and cortisol level in term infants. Further studies of larger populations including very preterm and small for gestational age infants are necessary to determine the balance of expression between GRalpha and GRbeta, and cortisol level.
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J. Matern. Fetal. Neonatal. Med. · Nov 2011
The effect of cesarean delivery rates on the future incidence of placenta previa, placenta accreta, and maternal mortality.
The overall annual incidence rate of caesarean delivery in the United States has been steadily rising since 1996, reaching 32.9% in 2009. Primary cesareans often lead to repeat cesareans, which may lead to placenta previa and placenta accreta. This study's goal was to forecast the effect of rising primary and secondary cesarean rates on annual incidence of placenta previa, placenta accreta, and maternal mortality. ⋯ If cesarean rates continue to increase, the annual incidence of placenta previa, placenta accreta, and maternal death will also rise substantially.
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J. Matern. Fetal. Neonatal. Med. · Nov 2011
Case ReportsA noninvasive evaluation analysis of amniotic fluid embolism and disseminated intravascular coagulopathy.
Amniotic fluid embolism (AFE) is a complication of pregnancy with a high mortality rate. The diagnosis of AFE is currently based on clinical findings, acute respiratory distress, cardiovascular collapse during labor and delivery, and immediate massive postpartum hemorrhaging. The serum biological markers are unreliable, and their detection requires a long time intervals for result. An early diagnosis is very important and prompts the clinical management of the condition. ⋯ We show that these methods can be successfully applied to the diagnosis of AFE and predict the prognosis of DIC. We also show that CT scans can be applied to the diagnosis of pulmonary embolism, eliminating the need to pathology.
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J. Matern. Fetal. Neonatal. Med. · Nov 2011
Effects of implementing family-centered rounds (FCRs) in a neonatal intensive care unit (NICU).
(1) Evaluate impact of FCR on provider satisfaction and collaboration. (2) Evaluate impact of FCR on parent satisfaction with provider communication. ⋯ FCR was associated with enhanced collaboration among team members for NNPs and fellows. Parents' satisfaction scores increased post FCR on survey items regarding communication. Since NNPs and fellows are the primary communicators with parents, the increased satisfaction may reflect improved communication due to FCR. This added opportunity for open dialogue may also contribute to the increased parent satisfaction.
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J. Matern. Fetal. Neonatal. Med. · Oct 2011
ReviewEvidence-based platelet transfusion recommendations in neonates.
Even though for certain varieties of neonatal thrombocytopenia, intravenous immunoglobulin or corticosteroids are recommended as treatments, platelet transfusions represent the only specific therapy currently available for most thrombocytopenic neonates in NICUs. The majority of these NICU platelet transfusions, up to 98% in some recent reports, are given to prevent, rather than to treat, bleeding. The trigger limit of platelet count to prophylactically treat non-bleeding patients is generally arbitrary. ⋯ To increase benefits and safety, new widespread changes in platelet transfusion guidelines are necessary. New transfusion paradigms should not be based on reasoning alone, but on important experimental validation. The neonatologists would better accept them and more closely adhere to.